What topical cream is recommended for stage one pressure ulcers (pressure sores)?

From the Guidelines

For stage one pressure ulcers, moisturizers and barrier creams are typically recommended as the primary topical treatment. Products containing dimethicone, zinc oxide, or petrolatum such as Aquaphor, Desitin, or Vaseline are effective choices 1. These should be applied gently to clean, dry skin 2-3 times daily or after each cleansing. No prescription medications are usually needed at this stage since the skin is still intact with only redness and no open wounds. These products work by creating a protective barrier that prevents moisture loss, reduces friction, and protects the skin from further damage. Additionally, it's crucial to relieve pressure on the affected area by repositioning every 2 hours, using pressure-redistributing surfaces like foam mattresses, and keeping the skin clean and dry. Early intervention with these measures can prevent progression to more severe stages of pressure ulcers, where more advanced wound care would be required. Some key points to consider include:

• The use of support surfaces, such as mattresses and overlays, to reduce pressure on the affected area 1.
• The importance of nutritional supplementation, including protein and amino acids, to promote wound healing 1.
• The role of electrical stimulation as an adjunctive therapy to accelerate wound healing 1.
• The need for regular repositioning and skin care to prevent further damage and promote healing 1.

From the Research

Topical Creams for Stage One Pressure Sores

• There is limited evidence to support the use of specific topical creams for stage one pressure sores 2, 3, 4, 5, 6.
• A study comparing hydrocolloid dressings, phenytoin cream, and simple dressings for the treatment of pressure ulcers found that hydrocolloid dressings were more effective for stage I ulcers 3.
• Another study found that hydrogel dressings may be effective for treating pressure ulcers, but the evidence is limited and more research is needed 4.
• A study on the clinical course of stage 1 pressure ulcers found that most stage 1 ulcers are reversible, but some may deteriorate to a higher stage if not properly managed 5.
• A skin care program that included consistent education, preventive care, assessment, documentation, and treatment was successful in preventing and treating pressure sores and skin tears in a residential Alzheimer's disease unit 6.

Recommended Topical Creams

• Phenytoin cream may be used as a topical agent for stage one pressure sores, but its effectiveness is unclear compared to other treatments 3.
• Hydrocolloid dressings may be a suitable option for stage one pressure sores, as they have been shown to be effective in promoting healing 3.
• Hydrogel dressings may also be considered, but more research is needed to determine their effectiveness compared to other treatments 4.

Key Considerations

• The use of topical creams for stage one pressure sores should be based on individual patient needs and wound symptoms 2, 3, 4, 5, 6.
• A comprehensive skin care program that includes preventive care, assessment, documentation, and treatment is crucial for preventing and managing pressure sores 6.